About Me

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Personality Disorders are like tips of icebergs. They rest on a foundation of causes and effects, interactions and events, emotions and cognitions, functions and dysfunctions that together form the individual and make him or her what s/he is. I have always been interested in people, their ways of thinking and behaving. Studying psychology has partially satisfied my curiosity, however, I have also ended up more intrigued then ever! I have a great interest in neuropsychology or simply, the way our brains work. I have worked in various mental health environments and have seen the effects that absence of good mental health can have on people. However, I have also become much more aware of the ignorance and stigma, which is unfortunately, still attached to mental illnesses and mental instabilities. I have set up a web site as well as this blog to promote the awareness of mental health and the related issues, to help eliminate the prejudiced thinking prevalent in our societies. I hope both will develop into useful resources for different individuals and I look forward to all the interesting comments and posts from the readers, who are all welcome to sign up to the blog.

Wednesday 21 December 2011

Mindfulness - what is it?

Mindfulness is an ancient Budhist practice which is very relevant for life today. It refers to a psychological quality that involves bringing one's complete attention to the present experience on a moment to moment basis. It could also be described as kind of non-judgemental, present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field is acknowledged and accepted as it is.

Mindfulness is actually very simple concept. It is simply a practical way to notice thoughts, physical sensations, sights, sounds, smells – anything we might not normally notice. The actual skills might be simple, but because it is so different to how our minds normally behave, it takes a lot of practice. Mindfulness can simply be noticing what we don't normally notice, because our heads are too busy in the future or in the past - thinking about what we need to do, or going over what we have done.

For example, Carol Vivyan, explains how we are simply often set on auto-pilot in many activities of our life. In a car, we can sometimes drive for miles on automatic pilot, without really being aware of what we are doing. In the same way, we may not be really 'present' moment-by-moment, for much of our lives: We can often be 'miles away' without knowing it.On automatic pilot, we are more likely to have our "buttons pressed”: Events around us and thoughts, feelings and sensations in the mind (of which we may be only dimly aware) can trigger old habits of thinking that are often unhelpful and may lead to worsening mood.
By becoming more aware of our thoughts, feelings, and body sensations, from moment to moment, we give ourselves the possibMility of greater freedom and choice; we do not have to go into the same old “mental ruts” that may have caused problems in the past.

Mindfulness training has at least 5 broad beneficial effects, according to Felicia Huppert, Professor of Psychology of the University of Cambridge's Well-Being Institute. Specifically, mindfulness promotes:
  • increased sensory awareness
  • greater cognitive control
  • enhanced regulation of emotions
  • acceptance of transient thoughts and feelings
  • the capacity to regulate attention

Mindful breathing

The primary focus in Mindfulness Meditation is the breathing. However, the primary goal is a calm, non-judging awareness, allowing thoughts and feelings to come and go without getting caught up in them. This creates calmness and acceptance. The following link takes you to the Mindful Breathing Script/Handout created by Carol Vivyan to help you started.

Mindul Breathing Script

Emotion regulation

Many of our intrusive thoughts come with an emotional flavour. Often these are negative – we suddenly remember a recent argument, which makes us angry, or the time we embarrassed ourselves in front of others. It is all to easy to get caught up by these intrusive emotional thoughts and to ruminate on them at length. Again, mindfulness encourages a more de-centred perspective on these feelings: they should be noted, and let pass. "Simply recognising your feelings gives you a choice in how you are going to respond, rather than reacting automatically in ways that lead to trouble", says Professor Huppert.

Using mindfulness to cope with negative experiences

As we become more practised at using mindfulness for breathing, body sensations and routine daily activities, so we can then learn to be mindful of our thoughts and feelings, to become observers, and subsequently more accepting. This results in less distressing feelings, and increases our level of functioning and ability to enjoy our lives.

Jon Kabat-Zinn uses the example of waves to help explain mindfulness. Think of your mind as the surface of a lake or an ocean. There are always waves on the water, sometimes big, sometimes small, sometimes almost imperceptible. The water's waves are churned up by winds, which come and go and vary in direction and intensity, just as do the winds of stress and change in our lives, which stir up waves in our mind. It's possible to find shelter from much of the wind that agitates the mind. Whatever we might do to prevent them, the winds of life and of the mind will blow, do what we may

"You can't stop the waves, but you can learn to surf" (Kabat-Zinn 2004).

Sunday 9 October 2011

World Mental Health Day

Monday 10 October is World Mental Health Day and I would like to use it as an opportunity to urge the government to continue to invest in mental health services. 

Every year one in six of us will experience mental ill health, yet only a quarter will seek treatment. The social cost of mental ill health is over £100bn – more than the entire NHS budget – and half of all mental health problems begin before the age of 15.

The government’s recent mental health strategy “No Health without Mental Health” sets out how important mental well-being is to every one of us and how much still needs to be done to ensure that people affected by mental ill health enjoy the same chances in life as everyone else. 

People with mental health problems tell us they require services that meet both their mental health and social needs. Yet the current reductions in social care and support to the voluntary sector are having a significant impact on the lives of those who are already marginalised and living in poverty.

The British Psychological Society and a number of other professional organisations, including the Royal College of Nursing and the Royal College of Psychiatrists, have written an open letter to the health secretary to call for action to coincide with World Mental Health Day.

As well as continued investment in mental health services, they want to see an emphasis on recovery, job opportunities and fighting discrimination, and call for service users and carers to be involved at the outset in planning, delivering and evaluating mental health services

To read more about World Mental Health Day, click on the following links:



Friday 30 September 2011

The Power of Positivity by Dr Fred Von Gunten

Dear all,

I have just finished reading The Power of Positivity, an e-book written by Dr Fred Von Gunten who, I am really proud to say, was one of the first followers joining this blog. It is through his e-mails and the 'first-hand' account in his e-book that I have come to understand much better the life of a bipolar sufferer. Fred has lived with the bipolar for 50 years and was one of the first to receive Lithium when the FDA approved it in 1971. Fred's great belief in the 'power of positivity' is beautifully captured in the e-book, in which he focuses on the benefits of positivity over negativity.

I would like to recommend this e-book to all of you because, in my eyes, it is a 'must read' for anyone who either suffers from the disorder or has ever wondered what the bipolar might be about.  The following review offers a good introduction to the e-book, which can be yours within seconds for a tiny little fee of $1.99 USD. The access link is provided at the end of this post.

Review by: Linda Lee Rathbun on Sep. 05, 2011 : star star star star star
Anyone who has struggled with mental health issues, and anyone who wonders how they can achieve positive thinking in their life, will no doubt benefit from this book. The author shares his lifelong struggle with bipolar disorder, and offers ways to manage the disorder with medication and with the Power of Positivity. In this book, Fred Von Gunten has opened up his heart and life for all to learn from. It is only when experience is passed on that it becomes a learning tool, and in this case, also a positive force for everyone's life. I highly commend this book to all. Linda Lee Rathbun
(reviewed the day of purchase)
I would love to hear your thoughts on this. Please follow the link below:

https://www.smashwords.com/books/view/86502

Kindest Regards,

Denisa

Friday 2 September 2011

Understanding Psychotic Experiences

Psychotic experiences, such as hearing voices, are surprisingly common, but can lead to diagnoses such as schizophrenia or bipolar disorder.

WHAT ARE PSYCHOTIC EXPERIENCES?

Also referred to as psychosis – a psychiatric term that describes experiences such as hearing voices seeing things or holding unusual beliefs, which other people don't hear/see or share. The psychotic episodes that a person experiences usually consist of hallucinations (seeing, hearing or feeling things that aren't there) and delusions (holding unusual/unfounded beliefs such as paranoia or feelings of importance). Some delusional ideas can be extremely frightening; for example, someone might believe that other beings are placing thoughts in their head, or trying to control or kill them. These ideas are called paranoid delusions.
These symptoms can be very distressing for sufferers and can lead them to become withdrawn, depressed and suicidal so it is vital that sufferers of psychosis get help. Psychiatrists regard these types of experiences as symptoms, and, depending on other factors, they will base a diagnosis on them. The diagnosis could be severe depression, schizophrenia, bipolar disorder, paranoia, psychotic illness, schizoaffective disorder, or puerperal psychosis (a very severe form of postnatal depression). These diagnoses are not clear-cut, and people may receive different diagnoses at different times.
Everyone’s experiences are unique. The majority hear voices, which may be recognizable or unfamiliar. There may be one or many of them talking to, or about, an individual. They might be present occasionally, or all the time, interfering with ordinary life, making concentration and conversation difficult. The voices may be benign and helpful, or hostile and nasty. Some people hear only positive voices, and may not regard them as a problem, others hear only negative ones, which causes great distress. The sufferers may feel the voices are in control of their body and can hurt them or punish them if they don’t do as they’re told. This may cause them to cut themselves or carry out other harmful types of behaviour.
Other psychotic experiences can take form of non-verbal thoughts, images and visions, tastes, smells and sensations, which have no apparent cause. For example, feeling as if insects were crawling under your skin, having a sensation like an electric shock, or smelling something that other people around you can’t. 

WHAT CAUSES PSYCHOTIC EXPERIENCES?

Almost anyone can have a brief psychotic episode resulting from a lack of sleep, through illnesses and high fevers, or abusing alcohol or drugs. There is considerable evidence that psychotic experiences are connected to using cannabis in some vulnerable people. Experiences of this kind can also be a result of damage to the brain or dementia, of lead and mercury poisoning, or changes in blood sugar levels. There are different ideas about why psychotic experiences develop. But it’s generally thought that some people are more vulnerable to them, and that very stressful or traumatic events make them more likely to occur. A person's own attitude to their experience, as well as the attitude of those around them, also plays a part.
The experiences may involve biological changes in brain structure or brain chemistry, but its not clear whether these are the cause or the effect of the psychotic experience. Research into whether there’s an inherited vulnerability is inconclusive. If one member of a family is diagnosed with schizophrenia or bipolar disorder, then there seems to be more chance of another family member being similarly diagnosed, but no single gene has been found to be responsible. Early experiences in life may be important in helping to prevent, or contributing to, problems. One theory suggests that overcritical or over-protective families make people more vulnerable. 

TREATMENT

Psychosis can be treated in a number of ways once it has been diagnosed: anti-psychotic drugs, psychological therapies, hospitalisation and self-help.

LITERATURE

References:
http://www.mind.org.uk/

http://www.glasgowpsychology.co.uk/psychosis.htm

Thursday 11 August 2011

Histrionic Personality Disorder (HPD)

Like other personality disorders, histrionic personality disorder is diagnosed based on a psychological evaluation and the history and severity of the symptoms. There is a lack of research on the causes of the HPD and thus they are not definitively known. It is suggested however that biological, developmental, cognitive and social factors play a crucial role. This disorder (Cluster B) is characterised by constant attention seeking and discomfort from not being the centre of attention. Histrionics tend to interrupt others to dominate the conversation and are sometimes referred to as drama queens with their theatrical performances and gestures. Those with the disorder may dress provocatively to gain the attention they crave, and be sexually seductive in inappropriate situations. However, there is a difference between being dramatic and being histrionic. Many people exhibit HP characteristics but would not be classified as having the disorder. The following symptoms of HPD may characterize someone who is described as 'dramatic', however, only in those diagnosed with the HPD the symptoms will be exhibited to a pathological degree.

SYMPTOMS

  • Acting or looking overly seductive
  • Being easily influenced by other people
  • Being overly concerned with their looks
  • Being overly dramatic and emotional
  • Being overly sensitive to criticism or disapproval
  • Believing that relationships are more intimate than they actually are
  • Blaming failure or disappointment on others
  • Constantly seeking reassurance or approval
  • Having a low tolerance for frustration or delayed gratification
  • Needing to be the center of attention (self-centeredness)
  • Quickly changing emotions, which may seem shallow to others

TREATMENT

Treatment for HPD is difficult for a number of reasons. Often, sufferers do not believe that they have a personality disorder and do not believe they’re in need of therapy. Those who do seek treatment often do so for depression or anxiety – conditions that are frequently associated with HPD. The treatment usually involves psychotherapy and/or medication.

Many people with this disorder are able to function well socially and at work. Those with severe cases, however, might experience significant problems in their daily lives.

Sunday 31 July 2011

Personality Disorder – what is it actually?

Having talked to people from various backgrounds, I realize how many different definitions/ideas/images exist associated with the notion of a personality disorder. Therefore, it does not surprise me that it is often considered as one of the most controversial of all psychiatric diagnoses. There are no accurate figures, but an estimated 10% of the general population have some kind of personality disorder. Experts describe personality disorders as being ‘fuzzy at the edges’. One person may qualify for several different disorders, while a wide range of people may fit different criteria for the same disorder, despite having very different personalities.

Placing people into neat categories is almost impossible, because each individual is unique and personality is very complex. It’s a mistake to assume that giving people a diagnostic label means knowing more about them, and it’s too easy to use these terms in a judgemental way. Many of these diagnostic labels have been used in a way that stigmatises people.

Research from the Office of National Statistics states that as many as 5.4% of men have a personality disorder, and for women, it is 3.4%. Personality disorders are found more in younger age groups (25-44 year age group) and are equally common between males and females. In 1998, research carried out by the Office of National Statistics found that numbers of people with personality disorders are highest in institutional settings like prison, which has a population where 64% of male sentenced prisoners and 50% of female prisoners have been found to be suffering from a personality disorder.

Personality disorders typically start in adolescence and continue into adulthood. They may be mild, moderate or severe, and people may have periods of 'remission' where they can function well. They are caused by a combination of genetic reasons and experiences of distress or fear during childhood, such as neglect or abuse and can be broadly grouped into one of three clusters – A, B or C. NHS provides the following definitions of the groups.

Cluster A personality disorder

An individual regards other people as alien and usually shows patterns of behaviour that most people would regard as odd and eccentric. Others may describe them as living in a fantasy world of their own. An extreme example is paranoid personality disorder, where the person is extremely distrustful and suspicious.

 

Cluster B personality disorders

 

A person with a cluster B personality disorder struggles to regulate their feelings and often swings between positive and negative views of others. This can lead to patterns of behaviour that others describe as dramatic, unpredictable and disturbing. An example is borderline personality disorder, where the person is emotionally unstable, has impulses to self-harm and has very intense and unstable relationships with others.

 

Cluster C personality disorders

 

A person with a cluster C personality disorder struggles with persistent and overwhelming feelings of anxiety and fear. They tend to show patterns of behaviour that most people would regard as antisocial and withdrawn. An example is avoidant personality disorder, where the person appears painfully shy, is socially inhibited, feels inadequate and is extremely sensitive to rejection. The person may want to be close to others, but lacks the confidence to form a close relationship.

To know more about personality types follow the link to my related website.

Wednesday 29 June 2011

Coping with Panic Attacks

A panic attack is a severe attack of anxiety and fear which occurs suddenly, often without warning, and for no apparent reason. It is an exaggeration of the body's normal response to fear, stress or excitement. Panic attacks are extremely frightening and involve physical symptoms, including shaking, feeling faint, dizzy, confused or disorientated, rapid heartbeats, dry mouth, sweating, ringing in ears, hot or cold flushes, tingling or numbness in hands/ feet and chest pain.

During an attack, you may fear that the world is going to come to an end, or that you are about to die or go mad. The most important thing to remember is that, however dreadful you may feel during an attack, this is NOT going to happen. Panic attacks always pass and the symptoms are not a sign of anything harmful happening. The following is based on various useful resources provided by MIND – the leading mental health charity.

First Aid:

If you are having a panic attack, try cupping your hands over your nose and mouth, or holding a paper bag (not plastic!) and breathing into it, for about 10 minutes. This should raise the level of carbon dioxide in the bloodstream and relieve symptoms.

Other first-aid tips include running on the spot during a panic attack. If you feel unreal, carry and object, such as the photograph of a loved one, to anchor you in reality, or finger a heavily textured object (e.g. a strip of sandpaper). You could also distract yourself, by trying to focus on what is going on around you.

  • The first step is recognising that you have the power to control your symptoms.
  • Confront your fear – do not run away from it. You need to tell yourself that nothing bad is going to happen and the symptoms you are experiencing are caused by anxiety. Try to keep doing things and, if possible, do not leave the situation until the anxiety has subsided (Salkovskis, 2010)
  • Accept that a panic attack is unpleasant and embarrassing, but that it is not life-threatening or the end of the world. By going with the panic, you are reducing its power to terrify you.
  • Learn creative visualisation – for example, imagine you are in a place that symbolises peace and relaxation for you . You can practice this anywhere but, until you have got used to doing this, try sitting in a chair with your limbs as floppy as possible, and think of calming images.
  • Use positive, present-tense affirmations – you can use visualisation to focus on situations that you fear. Imagine the situation and speak positively to yourself: 'I am doing well', 'This is easy'. These can be said silently or out loud.
    (NB: If you have been used to thinking negatively, over a long period of time, you will need to practice every day.)
  • Learn a relaxation technique, which focuses on easing muscle tension and slowing down your breathing.
  • Practice correct breathing – to avoid hyperventilation (over-breathing), which leads to panic attacks. Avoid breathing shallowly, from the upper chest, and breath more slowly from the abdomen. Put one hand on your upper chest and the other on your stomach. Notice which hand moves as you breathe. The hand on your chest should hardly move but the hand on your stomach should rise and fall.
  • If necessary, make changes to your diet – eat regularly and avoid sugary foods and drinks, white flour and junk food to prevent unstable blood sugar levels , which can contribute to symptoms of panic. Caffeine, alcohol and smoking all contribute to panic attacks and are best avoided.
  • If the self-help does not help, consult your doctor
  • Therapies that can be considered include: Drug Therapy, Psychotherapy, Cognitive Behaviour Therapy (CBT), Behaviour Therapy as well as various Complementary and Alternative Therapies (e.g. acupuncture, aromatherapy, homeopathy).

Tuesday 14 June 2011

Do you have bipolar?

The first question that you need to ask is, if you indeed have this condition. Learning the signs and symptoms will help you to weigh the need to seek out medical attention. If any of your symptoms are severe or you are considering harming yourself, you must seek immediate medical attention as soon as possible.

Bipolar individuals will go through an alternating pattern of highs and lows that play on their emotions. The highs are called episodes of mania. The lows are episodes of depression. The intensity of these highs and lows will vary from person to person and from one episode to the next. For some, the symptoms can be quite mild but for others they can be quite severe. In addition to this, you may also have very normal times too.

During the manic phase, there are a number of symptoms that can be observed.
  • You may feel extremely happy and optimistic. You may feel euphoria. You may also have an inflated self esteem or ego.

  • You may have very poor judgement, and you may know this by being told by others that you’ve made the wrong decision.

  • Your speech can be very fast. Your mind is going crazy with thoughts (see earlier Racing Thoughts post below). You may be agitated and feel the need to move your body and your mind. Physical activity may be increased too.

  • Many will be aggressive in their behaviour.

  • Some people find this to be a time of problems with sleeping, problems with concentrating on what you should be doing. You may be easily distracted, and have problems getting tasks accomplished.

  • You can be reckless or you may take chances on things that you normally would not do.

The depressive side of bipolar is often associated with depression like symptoms. These symptoms can include the following, often more than one symptom.
  • Feeling very sad, very guilty or feeling that all is lost. Hopelessness is a common feeling here too. The trademark of a problem is that the symptom is unfounded and is persistent.

  • You may be very tired, often not caring about getting your tasks accomplished. You may lose interest in the things that you do daily, normally. Even those things that you love to do may not be done.

  • You may be very irritable, losing your temper for no real reason.

  • You may not be able to sleep although you are tired. You may not be hungry and some will lose weight because of not eating properly here.

  • Some have problems with pain, too. If you have pain that there is no real cause for, this can be a sign of depressive behaviour.

  • The most serious of all symptoms and signs of depressive behaviour is that of thoughts of suicide. If you have these thoughts, your condition needs immediate attention.

If you think that you have any of these symptoms, then you need to work with your doctor to be diagnosed. It is necessary to get treatment and treatment really can help you!

Tuesday 7 June 2011

Anxiety Disorders

ANXIETY is a normal response to stress or danger. At times it's helpful because it can help prepare the body for action, and it can improve performance in a range of situations. It only becomes a problem when it is experienced intensely and it persistently interferes with a person's daily life.
Depression and anxiety commonly occur together. Not everybody who is anxious is depressed, but most depressed patients have some symptoms of anxiety.

CAUSES:
Are not fully known, but things to do with your family, your body and what has happened to you in the past are all believed to be involved.
Studies have shown that some people are born more likely to have high levels of anxiety. You are probably more likely to suffer from an anxiety disorder if someone in your family does.
Drug use and some physical conditions can also lead to increased anxiety as can one or more events that cause significant adjustments in everyday life (e.g. marriage, injury or retirement).

SYMPTOMS:

1) Psychological:
  • Inner tension.
  • Agitation.
  • Fear of losing control.
  • Dread that something catastrophic is going to happen, such as a blackout, seizure, heart attack or death.
  • Irritability.
  • Feelings of detachment, as if being trapped in a bubble separate from the world.
2) Physical:
  • Racing heart beat (palpitations).
  • Breathing fast, feeling short of breath or finding it hard to 'get breath'.
  • Chest tightness.
  • Dry mouth, butterflies in the stomach, feeling sick.
  • An urge to pass urine.
  • Tremor.
  • Sweating.
Five major types of anxiety disorders are:

  • Generalized Anxiety Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Social Phobia (or Social Anxiety Disorder)

TREATMENTS:

1) Psychological: Often tried first. They may include learning about the symptoms and realising that though they are frightening, they are not medically dangerous. Relaxation techniques can also be helpful.
People with OCD can be taught 'thought stopping' techniques to prevent obsessional thoughts.
Phobias can be treated by a number of techniques including 'graded exposure'.

2) Medicines
- Diazepam , Lorazepam - effective in quickly relieving the symptoms of anxiety. However, the body rapidly becomes used to these drugs and they can be addictive. Should not be used for longer periods.

-Buspirone

- Other medicines can help some of the physical symptoms of anxiety, for example propranolol (eg Inderal LA) can slow a fast heart beat and reduce tremor.

Antidepressants – such as Prozac (fluoxetine), Seroxat (paroxetine), Lustral (sertraline) and Cipramil (citalopram) – these appear to be better for panic disorder and OCD. A newer antidepressant Cipralex (escitalopram) is also proving to be beneficial in many patients with anxiety and panic disorders. Other antidepressants such as Gamanil (lofepramine) and Edronax (reboxetine) may be helpful for social phobias.

Tuesday 31 May 2011

Racing Thoughts

It is normal for people to have several things going on in their minds at any given time. When planning for the day ahead, there are usually several things that should be done. But for some people, however, these multiple thoughts become too much for them to bear. They begin to show symptoms of irritability, uneasiness, slurred speech, and inability to concentrate.

Generally, racing thoughts are described as an event where the mind uncontrollably brings up random thoughts and memories and switches between them very quickly. Sometimes they are related, as one thought leads to another; other times they are completely random. A person suffering from an episode of racing thoughts has no control over his or her train of thought and this stops them from focusing on one topic or prevents sleeping.

Racing thoughts are not just "thinking fast." They are thoughts that just won't be quiet; they can be in the background of other thoughts or take over a person's consciousness. Thoughts, music, and voices might be zooming through one's mind. There also might be a repetitive pattern of voice or of pressure without any associated "sound". It is a very overwhelming and irritating feeling, and can result in losing track of time. Sometimes racing thoughts are accompanied by a pounding hearth or pounding pulses, including drumming in the ears.

The phenomenon called racing thoughts is distinct from "hearing voices," which is a symptom of schizophrenia, schizoaffective disorder, severe mania or other psychotic disorders.

Racing thoughts can be a symptom of bipolar disorder, depression, OCD or a variety of other mood and anxiety disorders. They are also associated with use of amphetamines and sleep deprivation. Treatment is available for each of these conditions.

There some suggestions put forward that can help with racing thoughts: 

  • Do crossword puzzles - helps you to focus your thoughts on something specific instead of letting them roam. 
  • Read a book  - Especially one in which you can become absorbed. 
  • The chalkboard technique - Imagine a blackboard in your mind. As each thought comes to you, it is "written" on the chalkboard, which you instantly erase. Keep doing this with every thought as it comes. Eventually, you will tire yourself out and/or the thoughts will cease.  
  • Write in a journal  
  • Use a tape recorder: Just tape record your thoughts. This way you can speak as fast as your thoughts come to you. Eventually you will exhaust those thoughts (as well as your voice), and be able to sleep.

You may also want to read an article by Jordana Mansbacher entitled: Anxiety Reactions and Techniques to Stop Racing Thoughts

Tuesday 24 May 2011

Treating Bipolar Disorder

If you have bipolar disorder, taking medication is the key to reducing the frequency and severity of mood episodes. However, bipolar medications are most effective when used in conjunction with therapy and healthy lifestyle choices, including diet, exercise and support networks. These factors play an important role in managing symptoms of mania and depression and will also determine how much of medication is required.

It can take a while to find the right bipolar medication and dose. Everyone responds to medication differently thus several drugs might be tried before the one that works in a particular case is found. It may also take some time to establish the optimal dose, so it is important to work closely with a doctor. This is crucial since the medication should be re-evaluated on regular basis because the optimal dose fluctuates along the changes in a lifestyle. Medication should be continued even if a person feels better as the likelihood of having a relapse is very high.

All prescription drugs come with risks, but if taken RESPONSIBLY and especially, if combined with therapy and healthy lifestyle, the risks will be minimized and the efficiency of the treatment maximized. Responsibly here refers to the following:

- Medication is taken as prescribed
- Track of side effects is noted/recorded
- Being aware of potential drug interactions

Common Mood Stabilizers used in the treatment of Bipolar Disorder are:

1) LITHIUM, which is the oldest and most well-known mood stabilizer, highly effective for treating mania. It can also help bipolar depression, however, it is not as effective for mixed episodes or rapid cycling. Lithium takes from one to two weeks to reach its full effect. If lithium is taken, it is important to have regular blood tests to make sure the dose is in the effective range.

2) ANTICONVULSANTS, which have been shown to relieve the symptoms of mania and reduce mood swings. These include:

-Valproic acid (Depakote) – often the first choice for rapid cycling, mixed mania or mania with hallucinations or delusions.
-Carbamazepine (Tegretol)
-Lamotrigine (Lamictal)
-Topiramate (Topamax)

3) Natural Mood Stabilizers

Other medications used in treatment of bipolar include:

- ANTIDEPRESSANTS, however their use is becoming increasingly controversial
- ANTIPSYCHOTIC MEDICATIONS
- BENZODIAZEPINES – fast acting sedatives that work within 30 minutes to an hour. These might be prescribed while a person is waiting for the medication to kick in, however these are also highly addictive so they should be used only as a 'temporary measure'.

Therapy

Research shows that people who take medication for bipolar disorder tend to recover much faster and control their moods much better if they also get therapy. Therapy helps with coping strategies, monitoring the progress and dealing with problems that the disorder is causing in one's life.

If anyone wants to share their personal experience with regards to the treatment of Bipolar Disorder, please do so. This may prove invaluable for other readers. Thanks.

Saturday 14 May 2011

Obsessive Compulsive Disorder (OCD) versus Obsessive Compulsive Personality Disorder (OCPD)

It has only been a few weeks since launching my personality disorders website and I must say, I am absolutely thrilled about the feedback and comments coming in. Many have already given their ideas and suggestions and I shall endeavour to consider and work on these to make sure that the site becomes a good and inspiring source of information.

A feedback from one OCD sufferer has initiated the content of this post, in which I would like to emphasize the DIFFERENCE between OCD and OCPD – two distinctly different conditions that are often the subject of much confusion. While they share similar names and some common symptoms between them, the two are very different forms of mental illness that should be recognized as such.

OCD is an anxiety-related disorder rather than a personality disorder. A person with OCD experiences frequent intrusive and unwelcome obsessional thoughts, often followed by repetitive compulsions, impulses or urges. Compulsions are repetitive physical behaviours and actions or mental thought rituals that are performed over and over again in an attempt to relieve the anxiety caused by the obsessional thoughts.

OCPD is a condition in which a person is preoccupied with rules, orderliness and control. It is a type of personality disorder marked by rigidity, control, perfectionism, and an over-concern with work at the expense of close interpersonal relationships. People with OCPD tend to stress perfectionism above everything else, and feel anxious when they perceive that things are not right. They may hoard money, keep their home perfectly organized, or be anxious about delegating tasks for fear that they will not be completed correctly.

So how do we best distinguish between the conditions?

As expressed by the OCD suffer herself, “...those with OCPD are usually controlling, dislike delegating, and rarely seek treatment of their volition as they think they are right, whereas those with OCD are tortured by anxiety and would do anything to get rid of their obsessions”.

The biggest difference between OCD and OCPD is the fact that obsessions and compulsions do not exist in OCPD in the same sense they exist for sufferers of OCD. OCD sufferers tend to spend much more of their time dealing with rituals and repeated actions than those with OCPD and they are usually distressed by having to carry out these tasks or rituals. In contrast, people with OCPD view activities such as excessive list making or organization of items around the home as necessary and even beneficial.

Finally, whereas the severity of OCD symptoms will often fluctuate over time, OCPD is chronic in nature, with little change in personality style. As such, both condition subsequently require a specific treatment.

Monday 25 April 2011

Personality Disorder Diagnosis - a Blessing or a Curse?

It is commonly agreed that by our late teens, or early 20s, the most of us have developed our own personality with our distinctive ways of thinking, feeling and behaving. Usually, our personality allows us to get on reasonably, if not perfectly well, with other people. However, for some people this does not happen. Their personality develops in a way that makes it difficult for them to live with themselves and/or other people. They are simply unable to learn from experience and to change their traits.

My experience from working in mental health environments confirms that those with a personality disorder often find it hard to make or maintain relationships. Such people are frequently unable to get on with friends, family or people at work and lack the ability to control feelings and behaviour. As such, they end up unhappy or distressed, often upsetting or harming other people. Having a personality disorder makes life difficult, so other mental health problems (such as depression, or drug and alcohol abuse) co-occur.

Psychologists have developed many personality inventories, i.e. The Minnesota Multiphasic Personality Inventory (MMPI) or the Millon Clinical Multiaxial Inventory (MCMI) and numerous projective tests, i.e. The Thematic Apperception Test (TAT) that allow clinicians to assess the patient's patterns of thinking, their worries or anxieties and thus directing them to a valid diagnosis. Furthermore, The Diagnostic and Statistical Manual of Mental Disorders (or DSM-IV-TR), published by the American Psychiatric Association, is now a widely recognized manual that provides standard criteria for the classification of mental disorders, enabling even faster diagnoses.

However, despite all the tools, one question remains unanswered. Is this goal of getting a fast diagnosis a blessing or a curse for those involved? As for me, I am still trying to find out...